Physical Rehabilitation for Ankle Injury

Overseen By Adam B Rosen, PhD

Age: 18 - 65

Sex: Any

Trial Phase: Academic

Sponsor: University of Nebraska

Must not be taking: Narcotics, Antidepressants, Antianxiety, Stimulants

Disqualifiers: Lower extremity surgery, Pregnancy, Vestibular disorder, Nerve disorder, Cognitive impairment, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 2

Duration: 4 weeks

42 Participants Needed

Trial Summary

Will I have to stop taking my current medications?

The trial excludes participants who are currently taking medications that may affect cognitive function, such as narcotics, anti-depressants, anti-anxiety agents, or stimulants. If you are taking any of these, you may need to stop them to participate.

What data supports the effectiveness of the treatment Physical Rehabilitation for ankle injury?

Research shows that physical rehabilitation, including exercises to improve range of motion and strength, can help people recover from ankle injuries. Studies indicate that aggressive rehabilitation often leads to good results, and specific rehabilitation strategies are effective for both severe ankle sprains and fractures. ^{1 2 3 4 5}

Is physical rehabilitation for ankle injuries generally safe for humans?

Research on physical rehabilitation for ankle injuries, including exercises and techniques like using resistance bands, shows it is generally safe for humans. These methods are commonly used to improve strength, balance, and range of motion after ankle injuries. ^{6 7 8 9 10}

How is the treatment 'Physical Rehabilitation' for ankle injury different from other treatments?

Physical Rehabilitation for ankle injury is unique because it focuses on a comprehensive approach that includes exercises to improve flexibility, strength, and balance, as well as the use of various physical therapy techniques like ice, heat, and electrical stimulation. This treatment is tailored to restore full function and prevent chronic issues, unlike other treatments that may not address all these aspects. ^{5 9 10 11 12}

What is the purpose of this trial?

Chronic ankle instability (CAI) is a common debilitating orthopedic condition that disrupts physical function and decreases quality of life. Not all CAI is the same. It can be mechanical ligamentous laxity, perceived disability often referred to as functional instability, or a combination of the two. However, clinicians and researchers most often combine all chronic ankle instability patients without considering these sub-groups, which may account for poor recovery and recurrence. The objective of this research is to determine functional and neurophysiological differences between sub-groups of CAI to allow for development of evidence-based rehabilitation which may improve patient outcomes. To accomplish this, the study will determine the differences among CAI sub-groups on performance of a traditional side-hop test and neurocognitive hop test, determine differences in neurophysiological response and motor control between CAI sub-groups during a lower limb and an ankle specific task, and determine the underlying neurophysiological effects of a 4-week neurocognitively enhanced balance training protocol among CAI subgroups. Time to complete each of the hop tests, cortical activation during the balance and force control tasks, and neurocognitive performance will be assessed to determine differences in performance and neurological function among subgroups of CAI

Research Team

Adam B Rosen, PhD

Principal Investigator

University of Nebraska

Eligibility Criteria

This trial is for individuals with chronic ankle instability (CAI) who are looking to improve their condition. The study aims to understand functional and neurophysiological differences in CAI subgroups, which will help tailor more effective rehabilitation programs.

Inclusion Criteria

Coper participants: a history of lateral ankle sprain, but no episodes of giving way in previous 12 months, CAIT score greater than 28

I have a history of ankle sprains and my ankle often gives way.

All participants must be physically active (participation in at least 90 total minutes of activity/week including running, walking, lifting weights, or playing a sport, etc.)

Exclusion Criteria

I have had surgery or a fracture in my leg.

I have a history of conditions like concussion that affected my thinking.

I have been diagnosed with a nerve or connective tissue disorder.

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Baseline Assessment

Participants undergo baseline assessments including side-hop test, choice-reaction hop test, and inversion-eversion force control

1 week

1 visit (in-person)

Treatment

Participants engage in a 4-week neurocognitively enhanced balance training protocol

4 weeks

Weekly visits (in-person)

Post-rehabilitation Assessment

Participants are reassessed using the same tests as baseline to evaluate changes post-rehabilitation

1 week

1 visit (in-person)

Follow-up

Participants are monitored for safety and effectiveness after treatment

4 weeks

Treatment Details

Interventions

• Physical Rehabilitation

Trial Overview The study tests the effects of a specialized 4-week balance training program on people with different types of chronic ankle instability. It measures performance on physical tasks and assesses changes in nerve system function and muscle control.

Participant Groups

Group I: Balance Training Experimental Treatment 1 Intervention

Exercises include (1) single-limb hops to stabilization, (2) hop to stabilization and reach, (3) unanticipated hop to stabilization, (4) single-limb stance activities, and (5) continuous choice-reaction hopping.

Who Is Running the Clinical Trial?

University of Nebraska

Lead Sponsor

Trials

563

Recruited

1,147,000+

Findings from Research

A systematic review of 21 studies found that training programs are more effective than conservative treatments for improving pain and function in patients with chronic complaints after ankle sprains.

There is limited evidence suggesting that proprioceptive training can reduce the recurrence of ankle sprains, while the effectiveness of surgical treatments remains unclear due to a lack of comparative studies.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Chronic complaints after ankle sprains: a systematic review on effectiveness of treatments. van Ochten, JM., van Middelkoop, M., Meuffels, D., et al.[2022]

Effective rehabilitation of foot and ankle injuries is crucial for full recovery and preventing chronic issues, involving both physical therapy modalities and rehabilitative exercises.

Rehabilitation strategies, including the use of thermal, mechanical, and electrical agents, aim to reduce pain and swelling while enhancing strength and proprioception, particularly for common injuries like lateral ankle sprains.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Rehabilitation of foot and ankle injuries. Losito, JM., O'Neil, J.[2005]

References

1. Australia pubmed.ncbi.nlm.nih.gov

Some benefit from physiotherapy intervention in the subgroup of patients with severe ankle sprain as determined by the ankle function score: a randomised trial. [2019]

2. United States pubmed.ncbi.nlm.nih.gov

Characteristics and Effectiveness of Postoperative Rehabilitation Strategies in Ankle Fractures: A Systematic Review. [2023]

3. United States pubmed.ncbi.nlm.nih.gov

Chronic complaints after ankle sprains: a systematic review on effectiveness of treatments. [2022]

4. England pubmed.ncbi.nlm.nih.gov

Primary Treatment of Ankle Trauma. [2019]

5. United States pubmed.ncbi.nlm.nih.gov

Rehabilitation and return to play after foot and ankle injuries in athletes. [2018]

6. United States pubmed.ncbi.nlm.nih.gov

Weight-bearing and mobilization in the postoperative care of ankle fractures: a systematic review and meta-analysis of randomized controlled trials and cohort studies. [2022]

7. United States pubmed.ncbi.nlm.nih.gov

A 4-week neuromuscular training program and gait patterns at the ankle joint. [2022]

8. United States pubmed.ncbi.nlm.nih.gov

Current concepts in the diagnosis and treatment of ankle sprains. [2004]

9. United States pubmed.ncbi.nlm.nih.gov

Rehabilitation of the Ankle After Acute Sprain or Chronic Instability. [2022]

10. United States pubmed.ncbi.nlm.nih.gov

Unique positioning for using elastic resistance band in providing strengthening exercise to the muscles surrounding the ankle. [2021]

11. United States pubmed.ncbi.nlm.nih.gov

Rehabilitation of foot and ankle injuries. [2005]

12. England pubmed.ncbi.nlm.nih.gov

Rehabilitation of ligamentous ankle injuries: a review of recent studies. [2019]